%0 Journal Article
%@ 14388871
%I JMIR Publications Inc.
%V 15
%N 8
%P e194
%T Enhancing Retention of an Internet-Based Cohort Study of Men Who Have Sex With Men (MSM) via Text Messaging: Randomized Controlled Trial
%+ Rollins School of Public HealthDepartment of EpidemiologyEmory UniversityGrace Crum Rollins Building, 4th Floor1518 Clifton Road NEAtlanta, GA, 30322United States1 404 727 20381 866 311 8234pssulli@emory.edu
%A Khosropour,Christine M
%A Johnson,Brent A
%A Ricca,Alexandra V
%A Sullivan,Patrick S
%K HIV infections/prevention and control
%K prospective studies
%K Internet/organization and administration
%K SMS text messaging
%K homosexuality
%K male/statistics and numerical data
%D 2013
%7 27.08.2013
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: Black and Hispanic men who have sex with men (MSM) are disproportionately affected by HIV in the United States. The Internet is a promising vehicle for delivery of HIV prevention interventions to these men, but retention of MSM of color in longitudinal Internet-based studies has been problematic. Text message follow-up may enhance retention in these studies. Objective: To compare retention in a 12-month prospective Internet-based study of HIV-negative MSM randomized to receive bimonthly follow-up surveys either through an Internet browser online or through text messages. Methods: Internet-using MSM were recruited through banner advertisements on social networking and Internet-dating sites. White, black, and Hispanic men who were ≥18, completed an online baseline survey, and returned an at-home HIV test kit, which tested HIV negative, were eligible. Men were randomized to receive follow-up surveys every 2 months on the Internet or by text message for 12 months (unblinded). We used time-to-event methods to compare the rate of loss-to-follow-up (defined as non-response to a follow-up survey after multiple systematically-delivered contact attempts) in the 2 follow-up groups, overall and by race/ethnicity. Results are reported as hazard ratios (HR) and 95% confidence intervals (CI) of the rate of loss-to-follow-up for men randomized to text message follow-up compared to online follow-up. Results: Of 1489 eligible and consenting men who started the online baseline survey, 895 (60%) completed the survey and were sent an at-home HIV test kit. Of these, 710 of the 895 (79%) returned the at-home HIV test kit, tested HIV-negative, and were followed prospectively. The study cohort comprised 66% white men (470/710), 15% (106/710) black men, and 19% (134/710) Hispanic men. At 12 months, 77% (282/366) of men randomized to online follow-up were retained in the study, compared to 70% (241/344) men randomized to text message follow-up (HR=1.30, 95% CI 0.97-1.73). The rate of loss-to-follow-up was non-significantly higher in the text message arm compared to the online arm for both white (HR=1.43, 95% CI 0.97-1.73) and Hispanic men (HR=1.71, 95% CI 0.91-3.23); however, loss-to-follow-up among black men was non-significantly lower among those who received text message follow-up compared to online follow-up (HR=0.78, 95% CI 0.41-1.50). In the online arm, black men were significantly more likely to be lost to follow-up compared to white men (HR=2.25, 95% CI 1.36-3.71), but this was not the case in the text message arm (HR=1.23, 95% CI 0.70-2.16). Conclusions: We retained >70% of MSM enrolled in an online study for 12 months; thus, engaging men in online studies for a sufficient time to assess sustained outcomes is possible. Text message follow-up of an online cohort of MSM is feasible, and may result in higher retention among black MSM.
%M 23981905
%R 10.2196/jmir.2756
%U http://www.jmir.org/2013/8/e194/